摘要
目的探讨医生的专业化程度对直肠癌根治性切除术质量的影响。方法纳入2007年7月-2009年12月收治且确诊为直肠癌的手术患者共679例,分为专业组(470例)和非专业组(209例),收集患者年龄、体质量指数(BMI)、肿瘤TNM分期、手术持续时间、术中出血量、术后胃肠功能恢复时间、术后并发症等围手术期指标,进行相关统计学分析。结果两组患者手术持续时间相当(P=0.322),但在专业组中患者术中出血量较非专业组少(P=0.008)。专业组患者术后拔除胃管时间(P=0.000)、拔除引流管时间(P=0.000)、首次进流质食物时间(P=0.002)、首次排便时间(P=0.007)和下床活动时间(P=0.001)均较非专业组提前,术后住院时间(P=0.152)与住院总时间(P=0.983)两组差异无统计学意义,且专业组术后并发症总发生率较低(P<0.05)。结论医生的专业化程度对直肠癌根治术患者围手术期的管理有显著影响,专业化程度高的直肠癌外科医生可为患者带来更好的手术效果。
Objective To investigate the influence of surgeon specialization upon the result of radical resection for rectal carcinoma.Methods A total of 679 patients with rectal carcinoma were retrospectively enrolled from July 2007 to December 2009.Patients were divided into Specialist group（470 cases） and non-specialist group（209 cases）.Patients？medical records such as patients？age,body mass index（BMI）,tumor TNM staging,operation time,blood loss,postoperative gastrointestinal functional recovery time and complication were reviewed and analyzed.Results There was no significant difference on the operation time（P=0.322） between two groups,but the patients in specialist group had less blood loss（P=0.008）.The days of Gastric Tube Removal（P0.001）,drainage tube removal（P0.001）,beginning oral feeding（P=0.002）,defecation（P=0.007）,and Ambulation post-operation（P0.001） of patients in specialist group were significantly less than those in non-specialist group.However,the total（P=0.983） and post operation length of stay（P=0.152） in hospital was not different between the two groups significantly.The total incidence of complication in specialist group was less significantly（P0.05）.Conclusions Surgeons？degree of specialization has an important impact on peri-operation management of patients with rectal carcinoma.Specialist can provide patients with better outcome of rectal surgery.
出处
《华西医学》
CAS
2013年第7期1017-1020,共4页
West China Medical Journal
关键词
专业化
直肠癌
手术质量
并发症
Specialization
Rectal carcinoma
Surgical quality
Complications
